The present invention is directed to tissue approximation forceps and method. The tissue approximation forceps of the present invention close a wound without everting the wound edges. The forceps are particularly useful when approximating a wound where tissue adhesive is to be used to secure the approximated wound edges.
Tissue adhesives using cyanoacrylate esters are used for the closure of simple wounds and lacerations. These tissue adhesives are quick and easy to apply. They polymerize readily upon contact with body fluids and tissues and are relatively non-toxic. Of the available cyanoacrylates, butyl esters and octyl esters are preferred for use in medical applications. The butyl and acetyl monomers polymerize into an adhesive that is tougher and more flexible than, for example, methyl ester versions. This yields a stronger wound repair. It has also been found that the longer chain monomers are less tissue toxic than methyl esters.
The proper use of cyanoacrylate tissue adhesives also affects their toxicity. Because the adhesives are absorbable, exposing a raw tissue surface to the adhesive enhances the toxic effects. When using tissue adhesives, it is recommended that the wound edges not be everted. Eversion can, for example, produce a V-shaped channel that retains a quantity of tissue adhesives and also exposes more of the cut edge of the adjacent tissue to the potentially toxic adhesive.
Prior art tissue forceps have many types of mating gripping surfaces, including rat-tooth surfaces, serrated surfaces and crossed hatched surfaces. The gripping surfaces of many prior tissue forceps close in a direction perpendicular to the surface of the skin. Normally, the prior art forceps indent the skin and evert the wound edges during closure.
Other types of prior art forceps or closing devices include clamps for approximating tissue sections as shown in U.S. Pat. Nos. 5,514,148 and 5,611,794.
The tissue approximation forceps and method, according to the present invention, approximates the tissue edges adjacent a wound or laceration without everting the wound edges.